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Tyler Jones

Professor Leonard 

ENG 1201.2V7

6 May 2022

FaceTime with the Doctor: How Telemedicine Benefits Society?

Health is a essential part of our lives. It enables us to live easier and happier lives

however, we still must worry about major issues inexplicably popping up. That is where

doctors come in. Doctors are able to perform routine checkups on us to attempt to catch

major health issues before they affect us or get bad. However, a traditional doctor visit

requires a patient to visit a brick-and-mortar office and see a doctor. Now, with the

advent of telemedicine many checkups can be performed from home, both by the doctor

and patient. That seems pretty scary though. Is it safe for a doctor to perform a checkup

from home? I will explore this topic in my essay, discussing everything from

teleoptometry to standard telemedicine.

Inequality is an issue prevalent in everyone’s minds within the world we live.

Whether that be in education or in medicine we should strive to achieve equality within

the country which we live in. Telemedicine is an easy way to achieve that. There is no

reason for medical experts to move to areas where they would not be able to do as much

good even though there may be people there who want or need their help who can’t

afford their aid otherwise or are unable to travel to their institution. That is important as if

you are unhealthy you cant work. And if you can’t work, your family can’t afford basic

human necessities such as food. And if you can’t afford basic human necessities then

your health will continue to decline to the point where you are malnourished and on the
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brink of starvation. It is better to completely avoid that vicious cycle and instead treat

people for their ailments before they lose all hope. (Schattauer.)

Telemedicine provides a cheap method for those in need of care without forcing

those close to them to have to drive them to any medical facilities. My first article

discusses the use of telemedicine to aid those with serious or terminal medical conditions.

The author shows how the advent of telemedicine helps those in hospice, who live far

from any doctors, receive the care they need after hours. The author tells of the many

forms of technology that can be used to accomplish this and ensure the best outcome for

the patient. (Namasivayam, et al.)

I know a decent amount about teleoptometry from my job and from my dad. We

both work for Luxottica and a large part of our jobs is facilitating the roll out of

teleoptometry equipment to LensCrafters stores around the country. Teleoptometry

allows stores that otherwise would be unable to have doctors to be able to have on staff

medical personnel because they can work remote. Having a doctor benefits the store in

every way. It increases sales, draws in more customers, and aids in keeping people

employed. Since staff earns a commission on sales, they have incentives to stay and to

work harder. Without access to optical professionals people loose quality of life, making

it harder to drive, harder to read, and harder to look at screens.

In a personal interview with Jason Jones, the director of EyeCare Systems at

Luxottica, we discussed the extensive preparation needed to verify that teleoptometry can

be used at any location. Jason is in charge of the roll out of teleoptometry to thousands of

LensCrafters stores, Target optical, and Lens crafters in Macys. Across all of those stores,

thousands of assessments are conducted constantly with numerous doctors on staff. Each
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location has between 1 and 4 exam lanes but even the stores with the most traffic are

unable to keep up with the demand for exams because there are only so many

optometrists in their area. “Most stores will have exam lanes dedicated to teleoptometry

and lanes dedicated to in house exams.” Stores with even three lanes struggle to fill them

all with optometrists and so they need telemedicine.

To keep a safe and stable working environment for telemedicine, extensive

infrastructure must be laid out to protect the exams. For the store to be upgraded to

telemedicine the store needs to, well, need telemedicine. If there is not enough demand to

warrant the use of telemedicine, there is no need to use it. Next, the store needs to have

doctors willing to use the exam lane with telemedicine. Without someone to fill the lane,

there is no reason to invest in it. Additionally, the store needs to have a good staff. A staff

able to handle the hassle that comes with a telemedicine lane.

From a technical aspect, a store needs first to have stable and fast internet. The

doctor needs to be able to quickly and accurately see images and scans with little latency

and full accuracy. The stores need very specific pieces of equipment that are able to

transfer data through data ports for maximum security. Since the doctor is not in location

with teleoptometry, stores need additional equipment such as a visual fields machine.

They need it to perform checks that the doctor would usually do in person. On the topic

of internet, the store requires dedicated doctor side internet to be able to run

teleoptometry for security reasons and reliability.

Because of the fears of the general public about the safety and continued utility of

telemedicine, it can sometimes be difficult for a company to adopt telemedicine in good

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faith. It is a huge risk because of the amount of money, time, and research that must be

used that no company wants to fail.

With Jason, I also discussed the issues with the rollout of telemedicine. In many

states, Ohio included, telemedicine is highly restricted and as such, Luxottica must appeal

the state to allow them to use telemedicine. And in many other states they face the same

issues. You see, some states allow Luxottica to hire the doctors directly while others

require the doctor to be an independent contractor so as to avoid companies holding a

monopoly on the doctors space. Because of this, telemedicine is made even more difficult

to rollout and even more issues are posed to its release.

While those are the needs of teleoptometry, the question still remains, what are

the benefits of teleoptometry? Well, teleoptometry is used primarily for remote locations

and for high traffic locations, each of which desperately need a doctor. Also, so called

‘dark’ stores that are without doctors need them desperately. But why is a doctor so vital?

Well, with a doctor, a store gains increased traffic and by virtue, sales. That benefits not

only Luxottica but also the stores employees who receive commissions the more sales

they earn.

Telehealth enables doctors to perform routine medical checks remotely, a feature

that helps both doctor and patient. It allows their schedules to be more flexible, limits

exposure to infectious disease and lessens costs of driving and childcare. Telemedicine

allows for the remote monitoring of patients who are thought to have any kind of illness

or medical condition. If it worsens, it is a simple task to have the patient brought to the

hospital to receive the care that they need. It maximizes medical efficiency by limiting
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the number of people who rush to the hospital because of false alarms and helps doctors

bring in patients who underestimate the severity of their condition. (“Managing”).

Telemedicine allows medical professionals to see factors that they couldn't see otherwise.

For example, an allergist could have you walk around your home so that they could

identify potential sources of an allergen. Being able to see the home environment of a

patient enables medical professionals to see factors that could be hidden during a visit to

the doctor’s office. Medical professionals can, with the help of telemedicine, assess the

home lives of children. Kids act differently in and out of their homes and it is a huge

asset to be able to sense whether or not they feel comfortable in their home environments.

(Hasselfeld).

Telemedicine provides access to medical experts who may currently be hundreds

of miles away from you, but with this amazing technology, they can still provide their

insights as to your condition. Areas near world renowned medical institutions such as

John Hopkins and the Mayo Clinic have ready access to some of the best doctors but

those without the means to travel to those areas would be unable to receive diagnoses and

recommendations from those specialists without telemedicine. Specialist doctors are able

to achieve miraculous results in their treatments of patients because of their extensive

knowledge of a medical condition. (Brody).

Telemedicine allows doctors and patients to be more comfortable by performing

routine actions in their home environments. Patients who may have social angst or have

severe germaphobia are able to stay where they feel safe and comfortable. Comfort is a

high priority with medical professionals and being able to cater to their patients in that

way is amazing.
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In an article by Wyatt Koma, the extensive use of telemedicine during the COVID

19 pandemic is discussed extensively. He states that “the vast majority of Medicare

beneficiaries with a usual source of care (95%), such as a doctor or other health

professional, or a clinic, nearly two-thirds (64% or 33.6 million) say that their provider

currently offers telehealth appointments, up from 18% who said their provider offered

telehealth before the pandemic.” (Wyatt.) Those statistics show that medical providers

saw all of the benefits that telemedicine provides to society. If so many companies can

see the benefits of telemedicine it should be clear to us that it is beneficial to society.

(Wyatt.)

Infographic from KFF by Wyatt Koma.

https://www.kff.org/medicare/issue-brief/medicare-and-telehealth-coverage-and-use-

during-the-covid-19-pandemic-and-options-for-the-future/
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A major problem with the widespread adoption of telemedicine is money. For

telemedicine to work, the company needs to invest massive sums of money into the

research and rollout of telemedicine as well as into training. All doctors and staff

personnel would need to know how to use all of the equipment and help patients who

may be having trouble connecting to the call. However, it is not only the company

performing the service that needs to invest a sum of money into it. The patient also needs

to have a device capable of joining the call and a stable connection so that they can

interact with their doctors and nurses safely and without fear of their data being hijacked.

If they have been lax with their internet password, bad players can connect to their

internet and see everything that is being communicated privately. The costs of

telemedicine may seem high however, if you think about it, factoring in the cost of a car

and gas it would be more expensive to go to the office.

While telemedicine seems like it could be unstable, a remarkable amount of work

goes into ensuring that it is as stable as possible. For example, I work at Luxottica, a

company working to roll out teleoptometry to many of their LensCrafters stores around

the country. I work as a part of a team that surveys stores to see what equipment they

have on site and because of this I also know what equipment they need to have to operate

as a teleoptometry site. The stores must have very specific iterations of the equipment so

that the doctor can perform remote checkups in addition to the store requiring fast doctor

side internet.

While telemedicine is immensely beneficial to society it still has its problems and

downsides. Misunderstandings due to failures of virtual communication can lead to

potentially dangerous situations such as medicinal mis dosing and missed vital
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appointments. Appointments made intended to be used with telemedicine can be easily

missed because of failures in internet or with cellular data. Those appointments could be

vital to the survival of patients. If a patient with a life-threatening condition needs to meet

with their doctor to discuss symptoms that they are experiencing that signal a major

problem and are unable to get on the meeting due to internet issues it could cost them

their life. Additionally, many elderly people who are naturally resistant to change and

have issues understanding new technologies. Language barriers can pose a significant

issue in telemedicine as it can limit the number of doctors that non-English speakers have

access to in America. However, the benefits that telemedicine provides to society far

outweigh the potential harms that it poses. (Gogia).

Table 1
Summary of recommendations with regards to telemedicine
Type Problem Possible solution Serious?
Clinical Care provision with less than Clinical Decision Support Yes
ideal information or using adaptive/learning
misinformation methods; IT should not
override the clinicians
Administrative Cross border care (multi- Governance co-operation No
jurisdictional?)
Administrative Care provision by relatively Ensuring guidelines (“Map Yes
less or untrained persons of Med” for Telehealth)
Technical Lack of emergency support and High bandwidth Yes
retrieval care connectivity; Systems
interoperability
Administrative Diversion of funding from Health economics and cost- No
more deserving immediate benefit analyses; Public-
problems (and lack of funding private funding models
through conventional
mechanisms)
Administrative/ Bias towards “best-connected” Scalable solutions; platform Maybe
Technical demographic (including independence of services;
developing world) Better penetration of
connectivity
Clinical Un-usability of patient remote Automated customized Yes
monitoring information personal surveillance
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Type Problem Possible solution Serious?

(including adverse events). systems; Enthusiasts and
constant requirement of trained promoters; Help and support
personnel, especially on on version change;
software upgrade
Technical Non-interoperability of Standards and open systems; No
monitoring devices/sensors
Technical User acceptability of new Participatory design; No
telehealth technology (games, Interventions targeting
avatars, immersion) youth; Training; Incentives
for learning and usage
Clinical Services established outside Include the service into the No
ordinary protocols, weak links traditional healthcare system
to EHRs and EHRs (if available);
Reimbursement No clear method of Creation of Telehealth Yes
reimbursement. Care access related care and
through unconventional means reimbursement protocols;
competing with regular engagement of insurance
channels companies;
Table created by Gogia et al. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5171569/

While the initial goal of telemedicine was to provide access to doctors to those

living in remote regions far from any medical institutions, now it provides many other

benefits to society. Telemedicine provides access to services such as mental health

professionals to those who may desperately need them but can’t make it to a physical

office. (Gajarawala).

Different opinions from experts in their respective fields are priceless.

Telemedicine offers ready access to them and their opinions. There are countless stories

of doctors who when meeting patients can readily diagnose their condition and save their

lives. With their advice on medication and treatment patterns a condition can be rapidly

improved. There are numerous different ways to diagnose and treat a medical condition

and with the advice of those who may have seen and treated the condition countless

times, dramatic improvement can occur.

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Bibliography

Wyatt Koma, Juliette Cubanski. “Medicare and Telehealth: Coverage and Use during the

COVID-19 Pandemic and Options for the Future.” KFF, 19 May 2021,

https://www.kff.org/medicare/issue-brief/medicare-and-telehealth-coverage-and-use-

during-the-covid-19-pandemic-and-options-for-the-future/.

Gogia, S, et al. “Unintended Consequences of Tele Health and Their Possible Solutions.

Contribution of the Imia Working Group on Telehealth.” Yearbook of Medical Informatics,

Schattauer GmbH, 10 Nov. 2016,

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5171569/.

Jones, Jason. Personal Interview. 24 March 2022.

“Managing Your Health in the Age of Wi-Fi.” Mayo Clinic, Mayo Foundation for Medical

Education and Research, 15 May 2020,

https://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/telehealth/art-

20044878.
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Hasselfeld, Brian. “Benefits of Telemedicine.” Johns Hopkins Medicine,

https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/benefits-of-

telemedicine.

Gajarawala, Shilpa N, and Jessica N Pelkowski. “Telehealth Benefits and Barriers.” The Journal

for Nurse Practitioners : JNP, Elsevier Inc., Feb. 2021,

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7577680/.

Brody, Jane E. “A Pandemic Benefit: The Expansion of Telemedicine.” The New York Times,

The New York Times, 11 May 2020,

https://www.nytimes.com/2020/05/11/well/live/coronavirus-telemedicine-telehealth.html.